vitamin-b-12 and Helicobacter-Infections

Current guidelines recommend surveillance for gastric adenocarcinoma in patients with extensive chronic atrophic gastritis (CAG), which is considered a premalignant condition. Although the association between vitamin B12 deficiency and CAG is well described, the indication for endoscopic investigation is only advised in patients with pernicious anaemia. Our case did not have evidence of autoimmune or

Topics: Female; Gastritis, Atrophic; Gastroscopy; Helicobacter Infections; Humans; Vitamin B 12; Vitamin B 12 Deficiency

Epidemiological studies focusing on the association between vitamin B

Topics: Epidemiologic Studies; Helicobacter Infections; Humans; Stomach Neoplasms; Vitamin B 12; Vitamins

Over the last few years, epidemiological studies have shown that infection with. We conducted a systematic review and meta-analysis to estimate the association between. A systematic literature search was conducted for relevant articles using PubMed, Web of Science, and Scopus database from inception to March 2020. The OR with 95% CIs was determined by meta-analysis of data extracted from the selected studies.. From 2384 primary articles, 6 studies were selected for systematic reviews and 4 studies distinctively (with 1274 participants: 553 cases and 721 controls) were selected for meta-analysis. The meta-analysed fixed effect model estimated the odds of having. CRD42019135683.

Topics: Adolescent; Adult; Anemia, Iron-Deficiency; Case-Control Studies; Data Management; Female; Folic Acid; Helicobacter Infections; Helicobacter pylori; Humans; Malnutrition; Micronutrients; Observational Studies as Topic; Pregnancy; Pregnancy Outcome; Risk Factors; Vitamin B 12; Young Adult

Many micronutrients depend on a healthy stomach for absorption. Helicobacter pylori chronic gastritis may alter gastric physiology affecting homeostasis of vitamins and minerals.. Systematic review to assess whether H. pylori infection is associated with reduced micronutrient levels (other than iron) in the plasma or gastric juice and whether low micronutrient levels are modified by eradication treatment.. Medline was searched for relevant publications from inception to June 2010. Studies describing micronutrient levels in H. pylori-infected and not-infected adults and/or the effect of eradication treatment on micronutrient levels were included.. Fifty-two publications were selected: 46 investigated the association between H. pylori infection and reduced micronutrient levels and 14 the effect of eradication treatment on micronutrient levels. Sixty-four studies investigated vitamins (23 ascorbic acid, four ß-carotene, 21 cobalamin, 11 folate, and five α-tocopherol) and 10 addressed minerals (one calcium, one copper, one magnesium, one phosphorus, three selenium, and three zinc). Pooled standardized mean differences in micronutrient levels showed positive associations with H. pylori infection for ascorbic acid (gastric juice, -1.087) and cobalamin (-0.744), and a positive effect of eradication treatment, which increased ascorbic acid in the gastric juice (-1.408) and serum cobalamin (-1.910). No significant association between infection and low folate levels was observed. Meta-analyses for other micronutrients were not performed owing to insufficient data.. Meta-analyses indicate that H. pylori infection is associated with reduced levels of ascorbic acid and cobalamin, supported by the positive effect of eradication treatment. For other micronutrients, further studies are needed.

Topics: Ascorbic Acid; beta Carotene; Helicobacter Infections; Helicobacter pylori; Humans; Iron, Dietary; Micronutrients; Vitamin B 12

Atrophic gastritis (AG) results most often from Helicobacter pylori (H. pylori) infection. AG is the most important single risk condition for gastric cancer that often leads to an acid-free or hypochlorhydric stomach. In the present paper, we suggest a rationale for noninvasive screening of AG with stomach-specific biomarkers.. The paper summarizes a set of data on application of the biomarkers and describes how the test results could be interpreted in practice.. In AG of the gastric corpus and fundus, the plasma levels of pepsinogen I and/or the pepsinogen I/pepsinogen II ratio are always low. The fasting level of gastrin-17 is high in AG limited to the corpus and fundus, but low or non-elevated if the AG occurs in both antrum and corpus. A low fasting level of G-17 is a sign of antral AG or indicates high intragastric acidity. Differentiation between antral AG and high intragastric acidity can be done by assaying the plasma G-17 before and after protein stimulation, or before and after administration of the proton pump inhibitors (PPI). Amidated G-17 will rise if the antral mucosa is normal in structure. H. pylori antibodies are a reliable indicator of helicobacter infection, even in patients with AG and hypochlorhydria.. Stomach-specific biomarkers provide information about the stomach health and about the function of stomach mucosa and are a noninvasive tool for diagnosis and screening of AG and acid-free stomach.

Topics: Achlorhydria; Antibodies, Bacterial; Biomarkers; Gastric Mucosa; Gastrins; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Humans; Mass Screening; Pepsinogen A; Pepsinogen C; Stomach Neoplasms; Vitamin B 12

Vitamin C is actively secreted in human gastric juice. Proton pump inhibitor therapy lowers the concentration of vitamin C in gastric juice and the proportion of the vitamin in its active antioxidant form i.e., ascorbic acid. This has secondary effects on intragastric nitrite chemistry, resulting in a rise in gastric juice nitrite levels. There is also some evidence that proton pump inhibitors may reduce the bioavailability of ingested vitamin C. The effect of proton pump inhibitors on vitamin C and nitrite chemistry is more marked in Helicobacter pylori-infected subjects. Proton pump inhibitors also reduce the absorption of vitamin B(12) probably by inhibiting intragastric proteolysis and, thus, its release from food required prior to binding to R-proteins and gastric intrinsic factor. Under certain circumstances, the treatment may lower serum vitamin B(12) levels. Proton pump inhibitor therapy reduces the absorption of non-heme iron and this effect has been employed in the management of hemochromatosis. It may also retard clinical response to iron supplementation.

Topics: Absorption; Ascorbic Acid; Biological Availability; Gastric Juice; Helicobacter Infections; Helicobacter pylori; Humans; Iron; Omeprazole; Proton Pump Inhibitors; Vitamin B 12; Vitamins

Anemia is a frequent finding in most diseases which cause malabsorption. The most frequent etiology is the combination of iron and vitamin B12 deficiency. Celiac disease is frequently diagnosed in patients referred for evaluation of iron deficiency anemia (IDA), being reported in 1.8%-14.6% of patients. Therefore, duodenal biopsies should be taken during endoscopy if no obvious cause of iron deficiency (ID) can be found. Cobalamin deficiency occurs frequently among elderly patients, but it is often unrecognized because the clinical manifestations are subtle; it is caused primarily by food-cobalamin malabsorption and pernicious anemia. The classic treatment of cobalamin deficiency has been parenteral administration of the vitamin. Recent data suggest that alternative routes of cobalamin administration (oral and nasal) may be useful in some cases. Anemia is a frequent complication of gastrectomy, and has been often described after bariatric surgery. It has been shown that banding procedures which maintain digestive continuity with the antrum and duodenum are associated with low rates of ID. Helicobacter pylori (H. pylori) infection may be considered as a risk factor for IDA, mainly in groups with high demands for iron, such as some children and adolescents. Further controlled trials are needed before making solid recommendations about H. pylori eradication in these cases.

Topics: Anemia; Anemia, Iron-Deficiency; Celiac Disease; Gastrectomy; Helicobacter Infections; Humans; Iron Deficiencies; Malabsorption Syndromes; Parenteral Nutrition; Vitamin B 12; Vitamin B 12 Deficiency

Pernicious anemia (PA) is a macrocytic anemia that is caused by vitamin B(12) deficiency, as a result of intrinsic factor deficiency. PA is associated with atrophic body gastritis (ABG), whose diagnosis is based on histological confirmation of gastric body atrophy. Serological markers that suggest oxyntic mucosa damage are increased fasting gastrin and decreased pepsinogen I. Without performing Schilling's test, intrinsic factor deficiency may not be proven, and intrinsic factor and parietal cell antibodies are useful surrogate markers of PA, with 73% sensitivity and 100% specificity. PA is mainly considered a disease of the elderly, but younger patients represent about 15% of patients. PA patients may seek medical advice due to symptoms related to anemia, such as weakness and asthenia. Less commonly, the disease is suspected to be caused by dyspepsia. PA is frequently associated with autoimmune thyroid disease (40%) and other autoimmune disorders, such as diabetes mellitus (10%), as part of the autoimmune polyendocrine syndrome. PA is the end-stage of ABG. Long-standing Helicobacter pylori infection probably plays a role in many patients with PA, in whom the active infectious process has been gradually replaced by an autoimmune disease that terminates in a burned-out infection and the irreversible destruction of the gastric body mucosa. Human leucocyte antigen-DR genotypes suggest a role for genetic susceptibility in PA. PA patients should be managed by cobalamin replacement treatment and monitoring for onset of iron deficiency. Moreover, they should be advised about possible gastrointestinal long-term consequences, such as gastric cancer and carcinoids.

Topics: Anemia, Pernicious; Gastritis, Atrophic; Helicobacter Infections; Humans; Thyroiditis, Autoimmune; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

This review describes current knowledge of the main causes of vitamin B12 and folate deficiency. The most common explanations for poor vitamin B12 status are a low dietary intake of the vitamin (i.e., a low intake of animal-source foods) and malabsorption. Although it has long been known that strict vegetarians (vegans) are at risk for vitamin B12 deficiency, evidence now indicates that low intakes of animal-source foods, such as occur in some lacto-ovo vegetarians and many less-industrialized countries, cause vitamin B12 depletion. Malabsorption of the vitamin is most commonly observed as food-bound cobalamin malabsorption due to gastric atrophy in the elderly, and probably as a result of Helicobacter pylori infection. There is growing evidence that gene polymorphisms in transcobalamins affect plasma vitamin B12 concentrations. The primary cause of folate deficiency is low intake of sources rich in the vitamin, such as legumes and green leafy vegetables, and the consumption of these foods may explain why folate status can be adequate in relatively poor populations. Other situations in which the risk of folate deficiency increases include lactation and alcoholism.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biological Availability; Child; Child, Preschool; Developing Countries; Diet; Diet, Vegetarian; Female; Folic Acid; Folic Acid Deficiency; Helicobacter Infections; Helicobacter pylori; Humans; Infant; Intestinal Absorption; Male; Middle Aged; Nutritional Requirements; Nutritional Status; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

Topics: Administration, Oral; Anemia, Pernicious; Helicobacter Infections; Helicobacter pylori; Humans; Injections, Intramuscular; Malabsorption Syndromes; Postoperative Complications; Vitamin B 12; Vitamin B 12 Deficiency

It has been suggested that there is an association between Helicobacter pylori infection, reduced cobalamin absorption and cobalamin status and, consequently, elevated homocysteine levels. This would offer an explanation why H. pylori infection is associated with coronary heart disease. To date, more than 25 studies have been published that either deal with H. pylori infection and homocysteine, H. pylori infection and cobalamin status, or both. The design of these studies differs widely in terms of definition of H. pylori status, measuring cobalamin status, selection of study cohorts and geographical study areas. Therefore, results are fairly inconclusive at present and do not suggest a major role of H. pylori infection in the development of cobalamin deficiency and elevated homocysteine levels.

Topics: Anemia, Pernicious; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Homocysteine; Humans; Intestinal Absorption; Vitamin B 12; Vitamin B 12 Deficiency

Recent studies have suggested a relationship between Helicobacter pylori infection and various important micronutrients, including iron and vitamin B12, suggesting likely biological factors in the association between Helicobacter pylori and microcytic or macrocytic anaemia. There is some evidence that direct or indirect consequences of Helicobacter pylori gastritis on acid secretion account for the role of the bacterium in the absorption process of iron and Vitamin B12. The plasma, intragastric and mucosal concentration of different antioxidant compounds such as ascorbic acid, a-tocopherol and beta-carotene is also affected by Helicobacter pylori gastritis supporting the possible role of Helicobacter pylori in the multistep cascade leading to gastric carcinogenesis. The relationship between Helicobacter pylori infection and micronutrients is, therefore, a promising and, until now, poorly investigated field of research.

Topics: Antioxidants; Ascorbic Acid; Helicobacter Infections; Helicobacter pylori; Humans; Intestinal Absorption; Iron; Micronutrients; Selenium; Vitamin A; Vitamin B 12; Vitamin E

Topics: Animals; Autoantibodies; Diagnosis, Differential; Gastritis, Atrophic; H(+)-K(+)-Exchanging ATPase; Helicobacter Infections; Humans; Intrinsic Factor; Parietal Cells, Gastric; Prognosis; Vitamin B 12

Helicobacter pylori infection and iron and vitamin B(12) deficiencies are widespread in economically disadvantaged populations. There is emerging evidence that H. pylori infection has a negative effect on the absorption of these micronutrients. The aim of this study was to evaluate the effect of H. pylori infection on the efficacy of micronutrient (including iron and vitamin B(12))-fortified foods supplied for 1 year in marginally nourished children.. In all, 543 Indian children, aged 6-10 years, participated in a double-blind, randomized controlled intervention trial, receiving foods fortified with either high (100% Recommended Dietary Allowances (RDA)) or low (15% RDA) amounts of iron, vitamin B(12) and other micronutrients. The presence of H. pylori infection was diagnosed by the (13)C-labeled urea breath test at 11 months after the start of the intervention. Blood hemoglobin, serum ferritin (SF), total body iron and plasma vitamin B(12) were estimated at baseline and 12 months, and differences between these time points were assessed using an independent t-test.. Overall, the prevalence of H. pylori infection in this group of children was 79%. Baseline hemoglobin, SF, body iron and vitamin B(12) concentrations were not associated with H. pylori infection. The response to the intervention (either high or low amounts of iron and vitamin B(12) fortification) in terms of change in iron markers and vitamin B(12) status did not differ between children with and without H. pylori infection.. This study shows that the presence of H. pylori infection did not affect the efficacy of long-term iron and vitamin B(12) fortification in these marginally nourished children.

Topics: Breath Tests; Child; Child Nutrition Disorders; Deficiency Diseases; Double-Blind Method; Female; Ferritins; Food, Fortified; Helicobacter Infections; Helicobacter pylori; Hemoglobins; Humans; India; Iron; Iron, Dietary; Male; Micronutrients; Prevalence; Vitamin B 12

The effects of a 7.3-y supplementation with garlic and micronutrients and of anti-Helicobacter pylori treatment with amoxicillin (1 g twice daily) and omeprazole (20 mg twice daily) on serum folate, vitamin B-12, homocysteine, and glutathione concentrations were assessed in a rural Chinese population. A randomized, double-blind, placebo-controlled, factorial trial was conducted to compare the ability of 3 treatments to retard the development of precancerous gastric lesions in 3411 subjects. The treatments were: 1) anti-H. pylori treatment with amoxicillin and omeprazole; 2) 7.3-y supplementation with aged garlic and steam-distilled garlic oil; and 3) 7.3-y supplementation with vitamin C, vitamin E, and selenium. All 3 treatments were given in a 2(3) factorial design to subjects seropositive for H. pylori infection; only the garlic supplement and vitamin and selenium supplement were given in a 2(2) factorial design to the other subjects. Thirty-four subjects were randomly selected from each of the 12 treatment strata. Sera were analyzed after 7.3 y to measure effects on folate, vitamin B-12, homocysteine, and glutathione concentrations. Regression analyses adjusted for age, gender, and smoking indicated an increase of 10.2% (95%CI: 2.9-18.1%) in serum folate after garlic supplementation and an increase of 13.4% (95%CI: 5.3-22.2%) in serum glutathione after vitamin and selenium supplementation. The vitamin and selenium supplement did not affect other analytes and the amoxicillin and omeprazole therapy did not affect any of the variables tested. In this rural Chinese population, 7.3 y of garlic supplementation increased the serum folate concentration and the vitamin and selenium supplement increased that of glutathione, but neither affected serum concentrations of vitamin B-12 or homocysteine.

Topics: Adult; Amoxicillin; Anti-Bacterial Agents; Anti-Ulcer Agents; Asian People; Dietary Supplements; Dose-Response Relationship, Drug; Female; Folic Acid; Garlic; Glutathione; Helicobacter Infections; Helicobacter pylori; Homocysteine; Humans; Male; Micronutrients; Middle Aged; Omeprazole; Rural Population; Vitamin B 12

To investigate the prevalence of serological markers for chronic atrophic gastritis (AG) and Helicobacter pylori antibodies (HPAb) in an elderly population, and to examine the interrelationship and significance for cobalamin, folic acid and iron status and response to oral vitamin therapy.. The study included community-dwelling subjects (n=209), mean age 76 years, randomized to 4 month of oral daily treatment with 0.5 mg cyanocobalamin, 0.8 mg folic acid and 3 mg vitamin B(6) or placebo (double-blind). Biochemical tests were carried out before and after treatment.. AG, as indicated by a pepsinogen I/II ratio <2.9, occurred in 14% (26/190) and HPAb in 54% (102/190) of the subjects. AG subjects had higher levels of serum methylmalonic acid (MMA) (p<0.001), plasma homocysteine (tHcy) (p<0.05), lower haemoglobin (Hb) (p<0.01) and a higher prevalence of vitamin B(12) deficiency (p<0.01). HPAb was associated with AG, whereas AG subjects without HPAb had higher tHcy and MMA levels. There was no correlation between AG and iron status. Oral vitamin treatment led to greater (albeit non-significant) improvements in MMA, tHcy and total cobalamins in AG subjects compared to non-AG subjects.. AG is a common condition and is a significant determinant of vitamin B(12) status. AG is correlated to HPAB and lower Hb. Elderly AG subjects respond at least as well as non-AG subjects to oral treatment with B-vitamins in the doses employed.

Topics: Administration, Oral; Age Factors; Aged; Aged, 80 and over; Antibodies, Bacterial; Biomarkers; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Female; Folic Acid; Gastritis, Atrophic; Geriatric Assessment; Helicobacter Infections; Helicobacter pylori; Humans; Iron; Male; Multivariate Analysis; Prevalence; Probability; Reference Values; Regression Analysis; Risk Assessment; Severity of Illness Index; Treatment Outcome; Vitamin B 12; Vitamin B 6

Hyperhomocysteinaemia is an independent risk factor for atherosclerosis. It is often related to low levels of vitamin B12 and/or folate, enzymatic co-factors of methionine metabolism. Atrophic gastritis, often caused by Helicobacter pylori infection, may impair vitamin absorption.. To assess whether the presence of atrophic gastritis is associated with hyperhomocysteinaemia via deficiency of its vitamin co-factors.. Thirty-one patients with atrophic gastritis were recruited. The control group consisted of 28 patients with non-atrophic gastritis, matched with patients for sex, age and body mass index. The presence and degree of gastric atrophy were assessed by histology. H. pylori infection was assessed by histology/serology. Blood samples were collected for the measurement of homocysteine, vitamin B12 and folates.. Multiple logistic regression analysis showed that atrophic gastritis (odds ratio, 5.3; 95% confidence interval, 1.23-25.26; chi2=5.2; P=0.01) and low vitamin B12 (odds ratio, 3.7; 95% confidence interval, 1.03-22.08; chi2=3.6; P<0.05) were both predictors of hyperhomocysteinaemia. None of the other variables considered in the analysis, including H. pylori status, showed a significant association with hyperhomocysteinaemia.. The present study suggests that atrophic gastritis, rather than H. pylori infection per se, may be a contributing factor to hyperhomocysteinaemia, possibly via vitamin B12 malabsorption.

Topics: Female; Folic Acid; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Humans; Hyperhomocysteinemia; Malabsorption Syndromes; Male; Middle Aged; Odds Ratio; Regression Analysis; Risk Factors; Vitamin B 12

The role that vitamin B12 deficiency plays in upper gastrointestinal motor dysfunction is not clear. The aim of this study was to determine whether B12 replacement therapy improves prolonged gastric emptying time in dyspeptic patients with Helicobacter pylori infection.. The study included 34 H. pylori-positive patients who had low serum levels of B12 but had no other factors associated with altered gastric motility. Each patient underwent a radionuclide gastric emptying study before and after 3 months of B12 replacement therapy. Dyspepsia scores were calculated pretherapy and posttherapy using a semiquantitative scale. A vitamin B12 preparation (1000 microg/d) was given intramuscularly for the first 10 days and then orally for 80 days. H. pylori eradication therapy was delayed for 3 months until the posttreatment radionuclide study was completed.. The mean gastric emptying time before B12 treatment was significantly longer than that after treatment (230 +/- 190 minutes vs. 98 +/- 29 minutes, respectively; P < 0.0001). The mean dyspepsia score was also significantly improved by treatment (5.4 +/- 1.0 vs. 1.2 +/- 1.0, respectively; P < 0.0001).. Vitamin B12 deficiency appears to play an important role in the development of gastric dysmotility and its clinical consequences. Replacement therapy will improve gastric emptying in some patients with dyspepsia.

Topics: Adult; Dyspepsia; Female; Gastric Emptying; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Helicobacter pylori (H. pylori) infection is known as the most common cause of worldwide common chronic gastritis. Pathogenic mechanisms caused by H. pylori in diseases are still not fully understood. In addition, it has been reported that H. pylori can alter gene expressions in infected tissues and affect transcription factor activation. It is reported that aryl hydrocarbon receptor (AhR), which is a cytoplasmic transcription factor, functions in the immune system and plays a role in immune cells in barrier organs such as the gastrointestinal system, skin, and lungs. H. pylori infection affects the absorption of micronutrients such as trace elements, minerals, and vitamins by disrupting gastric secretion and acidification functions. Zinc (Zn) trace element is thought to be able to modulate the induction of AhR-responsive genes in endothelial cells. Although it is emphasized that trace elements are related with gastritis, relationship between Zn and AhR is not fully known, especially in chronic gastritis accompanied by H. pylori infection. In this study, serum levels of AhR, Zn, and AhR antagonist vitamin B12 were determined in chronic gastritis with H. pylori infection. Fifty volunteers diagnosed with H. pylori positive and negative chronic gastritis were included in this study. Collected from individuals participating were 5 ml of venous blood samples, and their serums were separated. AhR serum level of the study group was determined using enzyme-linked immunosorbent assay method. Zn concentrations in serum samples were measured using inductively coupled plasma atomic emission spectroscopy. When AhR and Zn serum levels were compared in H. pylori positive and negative chronic gastritis patients, it was found that AhR serum level of H. pylori positive chronic gastritis patients increased but it was not statistically significant (p = 0.595). However it was determined Zn and B12 serum levels were statistically significantly decreased (p < 0.001). This study has a crucial importance since to be the first one investigating relationship between serum AhR, Zn, and vitamin B12 levels in the pathogenesis of H. pylori gastritis in adults. Examination of AhR, Zn and B12 levels in H. pylori positive gastritis patients contributes to elucidating molecular mechanism of the disease.

Topics: Adult; Endothelial Cells; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Receptors, Aryl Hydrocarbon; Vitamin B 12; Zinc

To determine the role of vitamin B12 deficiency in pernicious anemia and the efficacy of oral vitamin B12 replacement therapy given regardless of the etiology, and to compare the endoscopic and pathological findings in patients diagnosed with vitamin B12 deficiency.. The study included 216 patients, aged 18 - 65 years, diagnosed with vitamin B12 level < 200 pg/mL between May 2015 and May 2016. Evaluation was made of the demographic characteristics of the patients, diseases, drugs used, dietary habits, previous use of vitamin B12 replacement therapy, family history of vitamin B12 deficiency, laboratory test values, and neurological symptoms present at the time of presentation. Endoscopy was applied to all the patients included in the study. Anti-parietal cell antibody (APCA) and anti-intrinsic factor antibody (AIFA) analyses were applied to all patients.. Evaluation was made of a total of 216 patients diagnosed with vitamin B12 deficiency, comprising 145 (67.1%) females and 71 (32.9%) males. The mean vitamin B12 level of the patients was determined as 127 pg/mL at the time of presentation and 334 pg/mL after treatment. APCA positivity was determined in 40 (18.5%) patients, and AIFA positivity in 5 (2.3%) patients. Atrophy was determined endoscopically in 53 (24.5%) patients and pathologically in 90 (41.7%). Helicobacter pylori positivity was determined in 196 (90.7%) patients. A diagnosis of pernicious anemia (PA) was made in 4 (1.9%) patients (patients with AIFA positivity or APCA accompanied by corpus atrophy). APCA positivity was determined but not corpus atrophy in 36 (16.7%) patients and these cases were accepted as suspected pernicious anemia. In this study of 216 patients with vitamin B12 deficiency, stomach pathologies which could cause vitamin B12 deficiency (atrophic gastritis, HP, PA) and the responses to oral replacement therapy were investigated. As vitamin B12 absorption plays a role in the pathogenesis. Vitamin B12 deficiency can lead to atrophic gastritis, and this was determined with biopsy in 41.7% of the patients. APCA positivity was determined in 18.5% of the patients investigated with respect to autoimmune atrophic gastritis (pernicious anemia) and AIFA positivity in 2.3%. A diagnosis of PA was made in 4 (1.9%) patients from autoimmune marker positivity and the presence of corpus atrophic gastritis. HP was determined in 90.7% of the patients with vitamin B12 deficiency, and although no correlation was determined between HP and atrophy, HP positivity was determined in 84 (93.3%) of the patients with pathological atrophy. From the time of diagnosis, the patients in the study were prescribed 1,000 µg/day vitamin B12. At the 40-day follow-up examination, a significant increase was observed in the vitamin B12 levels of 92.5% of the patients. At the end of the study, as oral replacement therapy was seen to be effective to a great extent, even in patients with PA, it was concluded that for patients not responding to oral replacement therapy, it would be appropriate to apply parenteral vitamin B12 treatment.. In developing countries such as Turkey, the role of HP infection in vitamin B12 deficiency must be kept in mind. The incidence of atrophic gastritis and pernicious anemia is higher than expected in vitamin B12 deficiency. Thus, it can be concluded that it is appropriate to investigate patients with vitamin B12 deficiency with respect to atrophic gastritis and PA, and oral replacement therapy should be the first stage in the treatment of vitamin B12 deficiency.

Topics: Administration, Oral; Adolescent; Adult; Aged; Anemia, Pernicious; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Metformin is widely used for the treatment of type-2 diabetes (T2D) but was shown to cause vitamin-B. This descriptive cross-sectional study recruited T2D patients using metformin from a primary care center and examined their socioeconomic status, accompanying complaints, medication use, and hemogram parameters such as serum vitamin B. Study included 421 T2D patients on metformin regimen: 213 (50.6%) males and 208 (49.4%) females. The mean duration of diabetes was 9.88 ± 7.32 years, and the total metformin dose was 1925.5 ± 236.7 mg/d. Almost half of the participants (n = 199, 47.3%) had H pylori infection, and more than half (n = 222, 52.7%) had vitamin-B. This study supported the role of H pylori infection in vitamin-B

Topics: Aged; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metformin; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Gastric function,. Low serum B12 concentrations were associated with low B12 dietary intake but not with

Topics: Adolescent; Adult; Aged; Biomarkers; Diet; Diet Surveys; Female; Gastrointestinal Diseases; Helicobacter Infections; Helicobacter pylori; Humans; Mexico; Middle Aged; Nutritional Status; Odds Ratio; Prevalence; Risk Factors; Rural Population; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

As a worldwide infectious bacterium,. This study has been conducted on 289 patients who have met the inclusion criteria. Within these patients, 213 of them were. In conclusion, B12 deficiency was positively correlated with CagA positivity and gastric inflammatory activity.

Topics: Adolescent; Adult; Aged; Antigens, Bacterial; Atrophy; Bacterial Proteins; Female; Gastric Mucosa; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Stomach; Stomach Neoplasms; Virulence Factors; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Helicobacter pylori infection (HPI) is a prevalent infectious disease associated with gastric ulcer, gastric cancer, and many nongastrointestinal disorders. To identify genes that may serve as microbial markers for HPI, we performed shotgun metagenomic sequencing of fecal samples from 313 Chinese volunteers who had undergone a C14 breath test. Through comparing differences in intestinal microbial community structure between H. pylori-positive and H. pylori-negative individuals, we identified 58 HPI-associated microbial species (P < 0.05, Wilcoxon test). A classifier based on microbial species markers showed high diagnostic ability for HPI (AUC = 0.84). Furthermore, levels of gut microbial vitamin B12 (VB12) biosynthesis and plasma VB12 were significantly lower in H. pylori-positive individuals compared with H. pylori-negative individuals (P < 0.05, Wilcoxon test). This study reveals that certain alterations in gut microbial species and functions are associated with HPI and shows that gut microbial shift in HPI patients may indirectly elevate the risk of VB12 deficiency.

Topics: Adult; Aged; China; Female; Gastrointestinal Microbiome; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Phenotype; Vitamin B 12; Young Adult

To explore the correlation between serum vitamin B12 level and peripheral neuropathy in patients with chronic atrophic gastritis (CAG).. A total of 593 patients diagnosed with chronic gastritis by gastroscopy and pathological examination from September 2013 to September 2016 were selected for this study. The age of these patients ranged within 18- to 75-years-old. Blood pressure, height and weight were measured in each patient, and the body mass index value was calculated. Furthermore, gastric acid, serum gastrin, serum vitamin and serum creatinine tests were performed, and peripheral nerve conduction velocity and. Age,. Serum vitamin B12 levels in patients with chronic gastritis significantly decreased, and the occurrence of peripheral neuropathy had a certain correlation. CAG and

Topics: Adult; Aged; China; Female; Folic Acid; Gastritis, Atrophic; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Neural Conduction; Peripheral Nervous System Diseases; Risk Factors; Tibial Nerve; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Helicobacter Pylori (HP) infection is systematically screened for before carrying out bariatric surgery. Criteria to determine "at risk" patients and avoid systematic screening are lacking. We evaluated the prevalence of HP infection and associated predictive factors in a population of patients with class II and III obesity volunteering for bariatric surgery.. Observational, cross-sectional study of patients included in the severe obesity outcome network (SOON) cohort. All patients underwent HP screening. The relationship between plasma metabolic parameters and vitamin levels, medical history and socio-economic parameters, and HP infection was analyzed.. Data from 201 patients, median age 43 years [IQR 35; 52] (81% female) were analyzed. Forty-four patients (22%) were infected with HP and successfully treated, most with a single course of treatment, either combined antibiotics or Pylera®. HP infection was associated with social precariousness as defined by the French "Evaluation de la Précarité et des Inégalités de santé dans les Centres d'Examens de Santé" (EPICES) score (Evaluation of Poverty and Health Inequalities in Health-Assessment Centers) (OR, 1.027; 95% CI, 1.008-1.046; p < 0.004) and with higher levels of vitamin B. The prevalence of HP infection was 22% and was associated with social precariousness. Plasma glucose/insulin and lipid/lipoprotein profiles, liver enzymes or vitamin deficiencies were not associated with HP infection. The number of characteristics associated with HP infection was insufficient to define patients who do not require HP screening before bariatric surgery.

Topics: Adult; Bariatric Surgery; Cohort Studies; Cross-Sectional Studies; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Mass Screening; Middle Aged; Obesity, Morbid; Prevalence; Vitamin B 12

Lymphocytic gastritis is an idiopathic disease, characterized by intraepithelial infiltration of large numbers of T lymphocytes and often described in association with coeliac disease and Helicobacter pylori infection. Although usually associated with iron deficiency anaemia, there is no description on the association between lymphocytic gastritis and secondary vitamin B

Topics: Aged; Anemia; Chronic Disease; Ferrous Compounds; Gastritis; Helicobacter Infections; Helicobacter pylori; Hemoglobins; Humans; Male; Recurrence; T-Lymphocytes; Vitamin B 12; Vitamin B 12 Deficiency

The purpose of this study was to evaluate the association between vitamin B12 levels and Helicobacter Pylori infection and to examine the clinical usefulness of holotranscobalamin (holoTC) measurement in children.. Thirty patients between 6 and 15 years of age, who were diagnosed as H. pylori infected by C(14) urea breath test, and 26 controls were enrolled in the study. Tests for complete blood count, serum vitamin B12 and folate, plasma total homocysteine, and holoTC levels were performed in each patient in the study and control groups.. Mean plasma holoTC concentrations were significantly lower in children with H. pylori infection before treatment (median 23.7 pmol/L (12.9-37.1 pmol/L)) versus after treatment (median 38.2 pmol/L (21.2-61.4 pmol/L)) and controls (median 36.1 pmol/L (12.6-58.7 pmol/L)).. The findings of our study suggest that H. pylori infection has a reversible negative effect on vitamin B12 status reflected in a decreased level of plasma holoTC that normalizes upon treatment of the infection, while no change is observed in total plasma vitamin B12 .

Topics: Adolescent; Child; Female; Folic Acid; Helicobacter Infections; Helicobacter pylori; Humans; Male; Vitamin B 12

Vitamin B12 deficiency is frequent in older patients, and the main reason is pernicious anemia. However, vitamin B12 deficiency can occur in patients who do not have atrophic gastritis. The aim of the present study was to investigate factors affecting serum vitamin B12 levels in older patients with non-atrophic gastritis.. A total of 1256 out of 1607 patients aged over 60 years who had undergone upper gastrointestinal endoscopy for various reasons, and who had serum vitamin B12 value and were diagnosed as having "non-atrophic gastritis" were analyzed by means of factors affecting low serum vitamin B12 levels.. Non-atrophic gastritis patients were divided into two groups: patients with normal serum vitamin B12 (group I, n = 759) and patients with low serum vitamin B12 (group II, n = 497). The median serum vitamin B12 was 339 pg/mL (range 201-987 pg/mL) in group I and 180 pg/mL (range 50-200 pg/mL) in group II. Helicobacter pylori (n = 154 vs 325, P < 0.001), neutrophil activity (n = 176 vs 367, P < 0.001), intestinal metaplasia (n = 35 vs 14, P < 0.001) and inflammation (n = 230 vs 386, P < 0.001) were present significantly more often in group II compared with group I. A total of 785 patients were both negative for Helicobacter pylori and atrophy. Of these 785 patients, neutrophil activity (n = 56, [32.6%] vs 25, [4.4%], P < 0.001) and inflammation (n = 69, [40.1%] vs 82, [13.4%], P < 0.001) scores were present significantly more often in group II compared with group I.. Helicobacter pylori was present significantly more often in older patients whose serum vitamin B12 levels were ≤200 pg/mL, and Helicobacter pylori density was inversely correlated with serum B12 level. Upper gastrointestinal endoscopic examination should be suggested for elderly patients with serum vitamin B12 level ≤200 pg/mL. Geriatr Gerontol Int 2015; ●●: ●●-●●.

Topics: Age Factors; Aged; Aged, 80 and over; Biopsy, Needle; Case-Control Studies; Female; Gastritis, Atrophic; Gastroscopy; Geriatric Assessment; Helicobacter Infections; Helicobacter pylori; Humans; Immunohistochemistry; Incidence; Male; Middle Aged; Prognosis; Reference Values; Retrospective Studies; Risk Assessment; ROC Curve; Severity of Illness Index; Statistics, Nonparametric; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Cytokines; Helicobacter Infections; Helicobacter pylori; Humans; Recurrence; Stomatitis, Aphthous; Vitamin B 12

Topics: Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Humans; Vitamin B 12

Topics: Administration, Oral; Dose-Response Relationship, Drug; Female; Gastritis, Atrophic; Graves Disease; Helicobacter Infections; Helicobacter pylori; Hormone Replacement Therapy; Humans; Hypothyroidism; Intestinal Absorption; Iodine Radioisotopes; Middle Aged; Thyrotropin; Thyroxine; Vitamin B 12; Vitamin B 12 Deficiency

The association between Helicobacter pylori (HP) infection and concentration of folate or homocysteine are still unclear. The aim of the present study was to assess the effect of  HP infection on folate and homocysteine concentrations in patients infected with HP and healthy participants. We also assessed dietary intakes of folate, vitamins B6 and B12 in two groups. In this case-control study, 44 participants with HP-infection and 46 healthy controls were studied. Participants were recruited from those referred to the central laboratory of Tabriz University of Medical Sciences. Blood samples were collected to determine serum folate and homocysteine levels. The presence of both IgG and IgA in serum was considered as HP positive. Dietary intakes were assessed in all participants by 24-hour dietary recalls by trained interviewers for three days. The mean concentration of serum folate was significantly lower in HP-positive patients than in controls (8.49 nmol/L vs. 10.95 nmol/L, respectively; P=0.01). Although the mean concentration of serum homocysteine differed between groups, statistical significance was missed (HP infected patients: 9.35 µmol/L; healthy participants: 8.96 µmol/L; P=0.064). Macro- and micronutrient intakes showed no significant difference between participants with and without HP infection. In logistic regression models, there was a negative correlation between folate concentration and HP infection even after controlling for confounding factors (OR=0.82; CI95%=0.79-0.97). In this study, authors showed that a negative association presents between HP infection and serum  folate concentrations, but the homocysteine status was not differed significantly between HP-positive and HP-negative participants.

Topics: Case-Control Studies; Diet; Folic Acid; Helicobacter Infections; Helicobacter pylori; Homocysteine; Humans; Iran; Logistic Models; Vitamin B 12

We tested a model in which Helicobacter pylori seropositivity (Hps) predicted iron status, which in turn acted as a predictor for markers of 1-C metabolism that were then allowed to predict antioxidant status.. National Health and Nutrition Examination Surveys (NHANES 1999-2000) cross-sectional data among adults aged 20-85 y were analyzed (n = 3,055). Markers of Hps, iron status (serum ferritin and transferrin saturation (TS)); 1-C metabolism (serum folate (FOLserum), B-12, total homocysteine (tHcy), methylmalonic acid (MMA)) and antioxidant status (vitamins A and E) were entered into a structural equations model (SEM).. Predictors of Hps included older age, lower education and income, racial/ethnic groups (lowest among Non-Hispanic Whites), and lifetime cigarette smoking. SEM modeling indicated that Hps had a direct inverse relationship with iron status (combining serum ferritin and TS) which in turn was positively related to 1-C metabolites (higher serum folate, B-12 or lower tHcy/MMA) that were positively associated with antioxidant status (combining serum vitamins A and E). Another pathway that was found bypassed 1-C metabolites (Hps → Iron_st → Antiox). The sum of all indirect effects from Hps combining both pathways and the other indirect pathways in the model (Hps → Iron_st → OneCarbon; Hps →OneCarbon →Antiox) was estimated at β = -0.006±0.003, p<0.05.. In sum, of the total effect of H. pylori seropositivity on antioxidant status, two significant indirect pathways through Iron status and 1-Carbon metabolites were found. Randomized controlled trials should be conducted to uncover the concomitant causal effect of H. pylori eradication on improving iron status, folate, B-12 and antioxidant status among H. pylori seropositive individuals.

Topics: Adult; Aged; Aged, 80 and over; Antioxidants; Cross-Sectional Studies; Female; Folic Acid; Helicobacter Infections; Helicobacter pylori; Humans; Iron; Male; Middle Aged; Nutrition Surveys; United States; Vitamin B 12

The aim of the present study was to investigate whether Helicobacter pylori causes or triggers recurrent aphthous stomatitis (RAS) through cytokine gene polymorphism and/or cobalamin deficiency.. Thirty-six patients with RAS and 130 patients without RAS were genotyped for IL-1β (-511C/T) and IL-6 (-174G/C) and evaluated for H. pylori infection and serum cobalamin level.. The patient groups according to RAS had similar rates of H. pylori gastritis and interleukin genotypes/alleles, and there was a non-significant difference between serum cobalamin levels (p>0.05). RAS patients with H. pylori gastritis showed a higher frequency (51.9%) of GC IL-6 genotype than RAS patients without H. pylori gastritis (11.1%) (p=0.036). Non-GG genotype and C allele were increased in patients without RAS and with H. pylori gastritis (p<0.05). Patients with H. pylori gastritis showed a lower value of serum cobalamin without statistical significance, although this difference was more prominent in RAS patients (p=0.07).. The carriage of the C allele of IL-6 may lead a susceptibility to chronic gastric inflammation after contamination with H. pylori. If H. pylori infection is justified as a predisposing factor for RAS and its severity by further studies, we can speculate that subjects with genetic susceptibility to this infection may benefit from H. pylori eradication treatment with respect to RAS.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Helicobacter Infections; Helicobacter pylori; Humans; Interleukins; Male; Middle Aged; Polymorphism, Genetic; Stomatitis, Aphthous; Vitamin B 12; Young Adult

The aim of this study was to determine the relationship between serum vitamin B12 and Helicobacter(H.) pylori prevalence in women between 10-49 years.. This cross-sectional (descriptive and analytical) study was conducted in the city of Samirom located in Isfahan, Iran in 2013. The population studied consisted of 100 women between 10-49 years and they were selected by convenience sampling. Data collection tools was checklist in which its content validity and reliability were confirmed. The data were entered into SPSS 16 software and were analyzed using descriptive statistics methods and univariate and multivariate inferential statistics methods.. The mean age of the study population was 29.5 ± 1.04. Also 29% of the population studied was infected with H. pylori, and prevalence of serum vitamin B12 less than 160 was 47%. After adjusted the effect of confounder variables with multivariate logistic regression analysis, the odds of infected with H. pylori in peoples with vitamin B12 less than 160, was 4.8 times the peoples with vitamin B12 normal (Equal and greater than 160) that this different was statistically significant (P<0.001).. The results showed that serum levels of vitamin B12 is a determinant factor in the prevalence of H. pylori.

Topics: Adolescent; Adult; Child; Cross-Sectional Studies; Female; Helicobacter Infections; Helicobacter pylori; Humans; Iran; Middle Aged; Prevalence; Vitamin B 12; Young Adult

H. pylori infection and vitamin B12 (vB12) deficiency have high prevalence rates among Palestinians. It was observed that most people who suffered from vB12 deficiency were positive for H. pylori.. The correlation between H. pylori infection and vB12 deficiency was investigated in a representative segment of the Palestinian population. ELISA was used to determine levels of vitamin B12 (vB12) and anti-H. pylori IgA in sera from 238 participants from Al-Khalil district (Hebron), Palestine.. There was a strong negative Pearson's correlation coefficient (r = -0.45; P = 0.00001) between levels of anti-H. pylori IgA and vB12 levels in sera drawn from 238 participants (133 patients and 105 control subjects). Two important contaminating variables were identified in this study: healthy control subjects with elevated anti-H. pylori IgA titers and vB12-deficient patients testing negative for anti-H. pylori IgA antibodies. The exclusion of the sources of contamination resulted in a stronger negative correlation; r = -0.58 (P = 0.00001).. The study provided a good screening system that may predict vB12 deficiency before its actual manifestation. If not treated, asymptomatic subjects showing increased anti-H.pylori IgA titers (> 15 NTU/mL) are likely to be at risk of developing vB12 deficiency.

Topics: Adolescent; Adult; Antibodies, Anti-Idiotypic; Arabs; Biomarkers; Comorbidity; Enzyme-Linked Immunosorbent Assay; Female; Helicobacter Infections; Helicobacter pylori; Humans; Immunoglobulin A; Male; Middle Aged; Middle East; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Topics: Female; Helicobacter Infections; Helicobacter pylori; Humans; Kidney Failure, Chronic; Male; Vitamin B 12

Topics: Female; Helicobacter Infections; Helicobacter pylori; Humans; Kidney Failure, Chronic; Male; Vitamin B 12

Several genome-wide association studies (GWAS) have identified a strong association between serum vitamin B12 and fucosyltransferase 2 (FUT2), a gene associated with susceptibility to Helicobacter pylori infection. Hazra et al. conducted a meta-analysis of three GWAS and found three additional loci in MUT, CUBN and TCN1. Other GWAS conducted in Italy and China confirmed the association for FUT2 gene. Alpha-2-fucosyltransferase (FUT2) catalyzes fucose addition to form H-type antigens in exocrine secretions. FUT2 non-secretor variant produces no secretion of H-type antigens and is associated with high-plasma vitamin B12 levels. This association was explained by the influence of FUT2 on H. pylori, which is a risk factor of gastritis, a main cause of vitamin B12 impaired absorption. However, we recently showed that H. pylori serology had no influence on FUT2 association with vitamin B12, in a large sample population, suggesting the involvement of an alternative mechanism. GIF is another gene associated with plasma levels of vitamin B12 and gastric intrinsic factor (GIF) is a fucosylated protein needed for B12 absorption. Inherited GIF deficiency produces B12 deficiency unrelated with gastritis. We report 2 families with heterozygous GIF mutation, 290T>C, M97T, with decreased binding affinity of GIF for vitamin B12 and one family with heterozygous GIF mutation 435_437delGAA, K145_N146delinsN and no B12 binding activity of mutated GIF. All cases with vitamin B12 deficit carried the FUT2 rs601338 secretor variant. Ulex europeus binding to GIF was influenced by FUT2 genotypes and GIF concentration was lower, in gastric juice from control subjects with the secretor genotype. GIF290C allele was reported in 5 European cases and no Africans among 1282 ambulatory subjects and was associated with low plasma vitamin B12 and anaemia in the single case bearing the FUT2 secretor variant. We concluded that FUT2 secretor variant worsens B12 status in cases with heterozygous GIF mutations by impairing GIF secretion, independently from H. pylori-related gastritis.

Topics: Adult; Anemia, Pernicious; Female; Fucosyltransferases; Galactoside 2-alpha-L-fucosyltransferase; Genome-Wide Association Study; Helicobacter Infections; Heterozygote; Humans; Intrinsic Factor; Male; Mutation; Vitamin B 12; Young Adult

Severely obese subjects have been found to show a high prevalence of distinct nutritional deficiencies even without any bariatric intervention but the underlying reasons remain obscure. We tested the hypothesis that gastric Helicobacter pylori infection is associated with increased nutritional deficiency rates. Taking advantage of our large database, we identified 404 patients who had undergone a gastroscopy--as a standard diagnostic assessment before bariatric surgery--along with a histological examination of gastric mucosal biopsies with concurrent nutritional blood measurements. Eighty-five (21 %) of the obese patients included in the study displayed a gastric H. pylori infection. Sex distribution, age and body mass index did not differ between H. pylori+ and H. pylori- patients (P > 0.29). Referring to nutritional markers, neither serum levels of total protein, albumin, calcium, phosphate, magnesium, ferritin, zinc, copper, vitamin B12, folate and 25-OH vitamin D3 nor respective deficiency rates differed between the H. pylori+ and H. pylori- patients group (all P > 0.13). Overall, 49.5 % of the bariatric candidates displayed at least one nutritional deficiency. Our data confirm previous reports on high prevalences of nutritional deficiencies in severely obese subjects. However, they do not provide evidence for a contributing role of gastric H. pylori infection to these nutritional alterations.

Topics: Adult; Calcium; Copper; Deficiency Diseases; Diet; Female; Ferritins; Folic Acid; Gastric Mucosa; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Humans; Magnesium; Male; Middle Aged; Obesity, Morbid; Patient Selection; Preoperative Period; Prevalence; Vitamin B 12; Zinc

Helicobacter pylori (HP) is a common infection worldwide and has been associated with severe morbidity. The level of vitamin B 12 in HP-infected chronic kidney disease (CKD) patients is reported to be lower than in the general population. The present study has been designed to evaluate the vitamin B 12 level in HP-infected CKD patients. We assessed the serum levels of vitamin B 12 in 50 CKD patients with positive HP serology, one and three months after the eradication of HP infection. There were significant differences between the serum levels of vitamin B 12 in the study patients before (806.98 ± 466.82) and after (760.36 ± 433.93) eradication treatment (P <0.001). We conclude that our study suggests the correlation between vitamin B 12 deficiency in CKD patients and the HP infection status.

Topics: Female; Helicobacter Infections; Helicobacter pylori; Humans; Kidney Failure, Chronic; Male; Middle Aged; Single-Blind Method; Vitamin B 12

The presence of Helicobacter pylori (HP) in the gastrointestinal tract may limit the absorption of levodopa. The objectives of this study were to investigate whether HP infection may affect the clinical response to levodopa as well as levodopa dose requirement in patients with Parkinson's disease (PD) as well as to investigate whether HP infection may affect plasma levels of vitamin B12, folic acid, and homocysteine. Seventy-five patients with PD diagnosed at least 4 years ago were included. Symptom fluctuations were assessed by UPDRS-IV and the WOQ9 wearing-off-scale. Plasma levels of vitamin B12, folic acid, and homocysteine were analyzed. Screening for HP was performed with a 13C-labeled urea breath test (Diabact UBT). A propensity-matched analysis was made where each patient in the HP-infected group was matched with one patient in the non-infected group with respect to age and gender. Of the 75 included patients, 20 were HP infected (27 %). Median Hoehn & Yahr scores were 3 in both HP infected patients and the matched group (n = 20). HP-infected patients had decreased "complications of therapy" with average total UPDRS-IV score of 4.8 ± 3.0 vs. 7.7 ± 3.8 (p < 0.05), despite no significant difference in levodopa equivalent dose. Wearing-off and sleep disturbance were significantly less common in the HP group (p < 0.05). There were no differences regarding vitamin B12, folic acid, or homocysteine values. HP infection in patients with PD may result in a decreased occurrence of symptom fluctuations according to this small study. This finding may be due to altered absorption of levodopa in the gastrointestinal tract in patients with HP infection, but further studies are required.

Topics: Aged; Antiparkinson Agents; Breath Tests; Female; Folic Acid; Helicobacter Infections; Helicobacter pylori; Humans; Intestinal Absorption; Levodopa; Male; Parkinson Disease; Treatment Outcome; Vitamin B 12

To determine the approximate incidence and clinical features of pernicious anemia in a Korean population, we retrospectively analyzed clinical data for patients with pernicious anemia who were diagnosed between 1995 and 2010 at five hospitals in Chungnam province. Ninety-seven patients were enrolled, who accounted for 24% of patients with vitamin B(12) deficiency anemia. The approximate annual incidence of pernicious anemia was 0.3 per 100,000. The median age was 66 (range, 32-98) yr, and the male/female ratio was 1.25. Anemia-associated discomfort was the most common symptom (79.4%), followed by gastrointestinal and neurological symptoms (78.4% and 38.1%, respectively). Pancytopenia was found in 36 patients (37.1%), and autoimmune disorders were found in 15 patients (15.5%). Antibody to intrinsic factor was detected in 62 (77.5%) of 80 patients examined, and antibody to parietal cells was detected in 35 (43.2%) of 81 patients examined. Of the 34 patients who underwent tests for Helicobacter pylori, 7 (12.5%) were positive. The anemia-associated and gastrointestinal symptoms resolved completely in all patients after intramuscular injection of cobalamin, whereas neurological symptoms remained in some. In conclusion, pernicious anemia is less frequent in Koreans than in Western populations; however, the clinical features of this disorder in Koreans do not differ from those of Western cases.

Topics: Adult; Aged; Anemia, Pernicious; Asian People; Autoimmune Diseases; Female; Gastrointestinal Diseases; Helicobacter Infections; Helicobacter pylori; Humans; Isoantibodies; Male; Middle Aged; Nervous System Diseases; Parietal Cells, Gastric; Republic of Korea; Retrospective Studies; Vitamin B 12

Genomewide association studies have shown a relation between plasma vitamin B-12 concentration and the 461G→A polymorphism of fucosyltransferase 2 (FUT2), a gene associated with susceptibility to Helicobacter pylori infection.. We evaluated in 2 populations the association of FUT2 461 G→A polymorphism with vitamin B-12 and related metabolic markers and investigated whether the influence of FUT2 on H. pylori serology is part of the mechanisms that underlie these associations.. The study included 1282 ambulatory subjects from Europe and West Africa. Blood concentrations of vitamin B-12, folate, homocysteine, and methylmalonic acid were measured. Genotyping was performed by real-time polymerase chain reaction. H. pylori serology testing was performed by using ELISA.. In univariate analysis, FUT2 461 A/A genotype was associated with higher plasma vitamin B-12 concentration in the total population (P = 0.0007) as well as in Europe (P = 0.0009) and in West Africa (P = 0.0015). Positivity for H. pylori serology was higher in West Africa (P < 0.0001) and was not associated with low plasma vitamin B-12. The prevalence of H. pylori-positive patients did not differ among FUT2 461 G→A genotypes (P = 0.2068). In multivariate analysis, FUT2 461 G→A genotype (P = 0.0008), but not positive H. pylori serology, was an independent predictor of plasma vitamin B-12 concentration.. This study confirms the influence of FUT2 461 G→A polymorphism on plasma vitamin B-12 concentration and showed no influence of H. pylori serologic status on this association in ambulatory subjects from Europe and West Africa.

Topics: Africa; Analysis of Variance; Enzyme-Linked Immunosorbent Assay; Europe; Female; Fucosyltransferases; Galactoside 2-alpha-L-fucosyltransferase; Genotype; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Polymorphism, Single Nucleotide; Prevalence; Vitamin B 12

H. pylori infection has been associated with many micronutrient deficiencies. There is a dearth of data from communities with nutritional deficiencies and high prevalence of H. pylori infection. The aim of this study was to determine the impact of H. pylori infection on serum levels of vitamin B(12), folate and homocysteine in patients with functional dyspepsia (FD).. One hundred and thirty-two patients with FD undergoing gastroscopy were enrolled. The serum was analyzed for B(12), folate and homocysteine levels before gastroscopy. H. pylori infection was diagnosed by histopathological examination of gastric biopsies and urea breath test. An independent sample t-test and the Mann-Whitney test were used to compare mean serum concentrations of biomarkers between H. pylori-positive and H. pylori-negative groups of patients. A Chi-square test was performed to assess the differences among proportions, while Spearman's rho was used for correlation analysis between levels of B(12) and homocysteine.. The mean age of the group was 40.3 ± 11.5 (19-72) years. Folate deficiency was seen in 43 (34.6%), B(12) deficiency in 30 (23.1%) and hyperhomocysteinemia in 60 (46.2%) patients. H. pylori was present in 80 (61.5%) patients with FD while it was absent in 50 (38.5%). Mean serum levels of B(12), folate and homocysteine in the H. pylori-positive group of patients were not significantly different from the levels in the H. pylori-negative group (357 ± 170 vs. 313 ± 136 pg/mL; p = 0.13), (4.35 ± 1.89 vs. 4.42 ± 1.93 ng/mL; p = 0.84); (15.88 ± 8.97 vs. 16.62 ± 7.82 μmol/L; p = 0.24); respectively.B(12) deficiency (≤200 pg/mL) was 23.8% in the H. pylori-positive patients versus 22.0% in the H. pylori-negative patients. Folate deficiency (≤3.5 ng/mL) was 33.8% in the H. pylori-positive group versus 36% in the H. pylori-negative group. Hyperhomocysteinemia (>15 μmol/L) was present in 46.2% of H. pylori-positive patients compared to 44% in the H. pylori-negative group. Correlation analysis indicated that serum B(12) levels were inversely associated with serum levels of homocysteine in patients with FD (rho = -0.192; p = 0.028).. This study demonstrated an inverse relationship between serum levels of B(12) and homocysteine in patients with FD. Moreover, no impact of the presence of H. pylori was found on B(12), folate and homocysteine levels in such patients.

Topics: Adult; Aged; Cross-Sectional Studies; Dyspepsia; Female; Folic Acid; Helicobacter Infections; Helicobacter pylori; Homocysteine; Humans; Male; Middle Aged; Vitamin B 12

To determine the relation between maternal Helicobacter pylori (H. pylori) infection and the occurrence of neural tube defects (NTDs) in newborns.. This hospital-based case-control study was carried out in Dezyani Teaching Hospital, Gorgan, Northern Iran from April 2007 to March 2009. Thirty-five mothers with NTD-affected newborns, and 53 mothers with healthy newborns were considered the cases and controls. A peripheral blood sample was obtained from all subjects, and H. pylori infections were tested by H. pylori serum antibody. The serum folic acid, vitamin B12, ferritin, and homocysteine concentrations were measured by laboratory tests. Data were analyzed using odds ratio (OR) and logistic regression.. Forty-three percent of cases, and 26% of controls were positive for H. pylori IgG antibody, and this difference was not significant. The H. pylori seropositivity non significantly increased the risk of NTD-affected pregnancies (OR: 2.08; 95% confidence interval [CI]: 0.84-5.17, p=0.11). Serum vitamin B12 deficiency was detected in 17% of cases and 13% of controls, and folic acid deficiency in 17% of cases and 13% of controls (p=0.61). The H. pylori seropositivity was non significantly associated with low serum folate (OR 1.93 CI: 0.58-6.4, p=0.34) and ferritin (OR 1.24; CI: 0.42-3.60, p=0.68).. Maternal H. pylori infection can increase the risk of occurrence of NTDs in newborns.

Topics: Bacterial Proteins; Case-Control Studies; Female; Ferritins; Folic Acid; Helicobacter Infections; Homocystine; Humans; Immunoglobulin G; Infant, Newborn; Logistic Models; Male; Neural Tube Defects; Northern Ireland; Odds Ratio; Pregnancy; Prenatal Exposure Delayed Effects; Retrospective Studies; Risk Factors; Vitamin B 12; Young Adult

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Adolescent; Amoxicillin; Anemia, Megaloblastic; Anti-Bacterial Agents; Clarithromycin; Helicobacter Infections; Helicobacter pylori; Humans; Lansoprazole; Male; Pancytopenia; Vitamin B 12; Vitamin B 12 Deficiency

Helicobacter pylori-associated corpus atrophy and autoimmune gastric atrophy share similar histopathologic and clinical aspects. In our study, the relation between Helicobacter pylori and autoimmune gastritis was investigated.. Eighty-two consecutive histologically and serologically Helicobacter pylori-positive and 96 Helicobacter pylori-negative patients were enrolled in the study. All patients underwent diagnostic upper esophagogastroduodenal endoscopy. Three biopsy specimens from the antrum and corpus greater curvature were obtained for histologic evaluation. Serum samples were collected for detection of anti-parietal cell antibody, anti-Helicobacter pylori IgG and vitamin B12. Statistical analyses were determined with Student t-test and chi-square test. Statistical significance was determined with a p-value <0.05.. Of 82 Helicobacter pylori-positive patients, 45 were female and 36 were male, with a mean age 45.1 ± 15.1. There was no significant difference in age, gender and corpus atrophy between the Helicobacter pylori-positive and -negative groups. Eleven Helicobacter pylori-positive patients (13.4%) and 14 (14.6%) Helicobacter pylori-negative patients were positive for anti-parietal cell antibody; the difference between the two groups was not statistically significant (p>0.05). Differences in esophagogastroduodenal endoscopy findings, antrum and corpus inflammation, antrum and corpus atrophy, and vitamin B12 levels were found to be insignificant between parietal cell antibody-positive and -negative groups (p>0.05).. We did not find any relation between Helicobacter pylori infection and anti-parietal cell antibody, a marker of autoimmune gastritis. Long-term follow-up of Helicobacter pylori-infected patients and also determination of the relation between eradication of Helicobacter pylori and autoimmune atrophic gastritis are needed.

Topics: Adult; Aged; Antibodies, Bacterial; Autoantibodies; Autoimmune Diseases; Case-Control Studies; Dihydrotachysterol; Female; Gastric Mucosa; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Immunoglobulin G; Male; Middle Aged; Parietal Cells, Gastric; Prevalence; Risk Factors; Seroepidemiologic Studies; Vitamin B 12

There is no published literature on the extent of vitamin B₁₂ deficiency in elderly Indians as determined by plasma vitamin B₁₂ levels and methylmalonic acid (MMA) levels. Vitamin B₁₂ deficiency is expected to be higher in elderly Indians due to vegetarianism, varied socio-economic strata and high prevalence of Helicobacter pylori infection. We therefore, studied the dietary habits of south Indian urban elderly population and measured vitamin B₁₂, MMA red cell folate and homocysteine (Hcy) levels.. Healthy elderly urban subjects (175, >60 yr) were recruited. Detailed history, physical examination and neurological assessment were carried out. Food Frequency Questionnaire (FFQ) for dietary analysis for daily intake of calories, vitamin B₁₂, folate and detailed psychological assessment for cognitive functions was carried out. Blood samples were analyzed for routine haematology and biochemistry, vitamin B₁₂, red cell folate, MMA and Hcy.. The mean age of the study population was 66.3 yr. Median values for daily dietary intake of vitamin B₁₂ and folate were 2.4 and 349.2 μg/day respectively. Sixty two (35%) participants consumed multivitamin supplements. Plasma vitamin B₁₂ level and the dietary intake of vitamin B₁₂ was significantly correlated (P=0.157). Plasma vitamin B₁₂ and Hcy were inversely correlated (P= -0.509). Red cell folate was inversely correlated with Hcy (P= -0.550). Significant negative correlation was observed between plasma vitamin B₁₂ and MMA in the entire study population (P= -0.220). Subjects consuming vitamin supplements (n=62) had significantly higher plasma vitamin B₁₂ levels, lower MMA levels and lower Hcy levels. There was no significant correlation between plasma vitamin B₁₂, MMA, Hcy and red cell folate and any of the 10 cognitive tests including Hindi Mental Status Examination (HMSE).. Our study is indicative of higher vitamin B₁₂ (2.4 μg/day) intakes in urban south Indian population. Thirty five per cent of the study population consumed multivitamin supplements and therefore, low plasma vitamin B₁₂ levels were seen only in 16 per cent of the study subjects. However, MMA was elevated in 55 per cent and Hcy in 13 per cent of the subjects.

Topics: Aged; Diet, Vegetarian; Erythrocytes; Female; Folic Acid; Helicobacter Infections; Helicobacter pylori; Homocysteine; Humans; India; Male; Methylmalonic Acid; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Some investigations, but not all, found that a chronic infection with Helicobacter pylori (Hp) is associated with deficiencies in B vitamins, elevated plasma total homocysteine concentrations (tHcy) and increased plasma levels of proinflammatory acute-phase proteins. It has been suggested that these factors promote atherogenesis and therefore could mechanistically explain why people infected with Hp might have an increased risk for cardiovascular diseases (CVD). Therefore we evaluated the association between Hp-infection, concentration of C-reactive protein (CRP), and status of various B vitamins in apparently healthy subjects.. In 69 subjects with proved Hp-infection and 21 healthy control subjects identified in a cross sectional study, blood samples were collected to determine serum folate, serum vitamin B12, serum methylmalonic acid (MMA), serum CRP and plasma vitamin B6 and plasma total homocysteine (tHcy).. The mean concentration of CRP was significantly higher in the Hp-positive collective than in controls. Although mean concentrations of vitamin B12, B6, and MMA differed between the groups, statistical significance was missed. However, the mean concentrations of homocysteine and folic acid were nearly the same in both groups. In univariate analysis a significant impact of Hp-status was shown on cobalamin (p=0.028; eta square: 0.055), and in multivariate analysis of variance the Hp-status had an impact on vitamin B12-values (p=0.028; eta square 0.057).. In this study Hp-infection shows no significant impact on status of B vitamins, but has a significant influence on CRP concentration. However, this study does not support the hypothesis that Hp-infection is related to CVD via elevated levels of tHcy.

Topics: C-Reactive Protein; Cross-Sectional Studies; Female; Folic Acid; Helicobacter Infections; Helicobacter pylori; Homocysteine; Humans; Male; Methylmalonic Acid; Middle Aged; Risk Factors; Vitamin B 12; Vitamin B 6

Helicobacter pylori is one of the most common causes of peptic ulcer disease worldwide and a major cause of chronic superficial gastritis leading to atrophy of gastric glands.. A total of 60 patients suffering from gastric disease due to H. pylori infection were evaluated. Endoscopy was performed and gastric biopsies were obtained for histopathology and urease test. Blood was simultaneously collected for the determination of the levels of vitamin B12 and the MCV. Vitamin B12 levels were determined by chemiluminescent assay.. Our results indicate that the mean vitamin B12 level +/- SEM for the total population, the H.pylori infected and non-infected patients were 264.5+/-22.9, 207.7+/-21.9 and 419.7+/-39.8 respectively. H. pylori was found in 71.7% (43/60) of the patients tested. The level of vitamin B12 was lower than 200pg/ml (deficient) in 67.4% (29/43) of patients tested positive for H. pylori.. H. pylori appears to be implicated in causing vitamin B12 deficiency.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Endoscopy, Gastrointestinal; Erythrocyte Indices; Female; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Virulence; Vitamin B 12; Vitamin B 12 Deficiency

We sought to explore the relationship between Helicobacter pylori infection and serum ferritin, vitamin B(12), folate, and zinc status among children. Fifty patients aged 5-18 years who underwent upper gastrointestinal endoscopy because of dyspeptic symptoms, were studied, prospectively. Patients were grouped as H. pylori positive (group 1, n=32) or H. pylori negative (group 2, n=18) by histopathologic examination and rapid urease test. Fasting serum ferritin, vitamin B(12), folate, and zinc levels of patients were measured. Both groups were indifferent according to age, gender, height standard deviation score (H(SDS)), and weight standard deviation score (W(SDS)). Serum ferritin levels were 33+/-26 and 50+/-46 ng/mL (P=.098), vitamin B(12) levels were 303+/-135 and 393+/-166 pg/mL (P=.042), folate levels were 9.64+/-3.2 and 9.61+/-2.8 ng/mL (P=.979), and zinc levels were 95+/-48 and 87+/-31 mug/dL (P=.538), in groups 1 and 2, respectively. Ferritin levels of 14 (43.8%) patients in group 1 and 6 (33.3%) patients in group 2 were below the normal range (P=.470). Serum vitamin B(12) levels of 9 children (28%) in group 1 and 2 children (11%) in group 2 were below the normal range (P=.287). The findings of the present study suggest that H. pylori infection has a negative effect on serum ferritin and vitamin B(12) levels in children. This negative effect on vitamin B(12) levels is rather marked in contrast to that on ferritin levels. H. pylori infection has no significant effect on serum folate or zinc levels among children.

Topics: Adolescent; Breath Tests; Child; Child, Preschool; Duodenum; Endoscopy, Gastrointestinal; Female; Ferritins; Folic Acid; Helicobacter Infections; Helicobacter pylori; Humans; Male; Prospective Studies; Stomach; Urease; Vitamin B 12; Zinc

We investigated the biochemical markers of bone metabolism in children with Helicobacter pylori infection. Biochemical markers of bone metabolism and serum levels of vitamin B12, ferritin and estradiol were measured in 41 H. pylori-positive (+) children (23 girls, 18 boys; aged 11.8+/-3 years). Serum levels of intact parathyroid hormone, ss-collagen I carboxy terminal telopeptide, total alkaline phosphatase (ALP), bone-specific ALP, N-terminal cross-links of human procollagen type I, N-mid-osteocalcin, calcium, phosphate, ferritin, and estradiol did not differ significantly between H. pylori(+) and H. pylori negative (-) children. Vitamin B12 levels were significantly decreased in H. pylori(+) compared to H. pylori(-) children. H. pylori infection was not accompanied by significant changes in markers of bone metabolism in children, although vitamin B12 levels were decreased. Further studies are required to clarify whether H. pylori infection causes time-dependent changes in bone turnover markers during the long course of this inflammatory disease.

Topics: Adolescent; Biomarkers; Bone and Bones; Bone Remodeling; Child; Child, Preschool; Collagen Type I; Estradiol; Female; Ferritins; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Male; Parathyroid Hormone; Peptides; Vitamin B 12

Previous findings for the Texas Neural Tube Defects Project suggested that while maternal access to nutrients is adequate, bioavailability of nutrients to the fetus is compromised in NTD-affected pregnancies. Helicobacter pylori could cause nutrient loss to the fetus. Folate, B12, and ferritin are depleted in H. pylori infection; these same deficiencies are related to NTD risk.. Using H. pylori IgG ELISA Test System, we tested for H. pylori serum antibodies in participants in the population-based case-control study component of the Texas Neural Tube Defect Project conducted along the Texas-Mexico border. Case-women had pregnancies affected by NTD (anencephalus, spina bifida, encephalocele) and resided and delivered in one of the 14 Texas-Mexico border counties from 1995 through 2000. Control-women were study area residents delivering normal live births during the same period.. Of 225 case- and 378 control-women, 103 cases and 156 controls provided questionnaire and H. pylori antibody data. H. pylori seropositivity was modestly associated with NTD-affected pregnancies (OR 1.4; 95% CI: 0.8-2.4). ORs of 2.0 or greater were seen in women younger than age 25 and with less than 7 years education.. Our findings intimate that H. pylori could play a role in NTD causation in certain populations. While results did not provide compelling support for this proposal, subgroup findings prompt us to advocate an evaluation of this hypothesis in developing nations among populations with higher prevalence of H. pylori, marginal nutrient intake, and young childbearing age.

Topics: Adult; Case-Control Studies; Female; Ferritins; Folic Acid; Helicobacter Infections; Helicobacter pylori; Humans; Malnutrition; Micronutrients; Neural Tube Defects; Pregnancy; Risk Factors; Surveys and Questionnaires; Texas; Vitamin B 12

Elevation of plasma homocysteine (Hcy) level has been implicated in the pathogenesis of slow coronary flow (SCF) as it can severely disturb vascular endothelial function. Helicobacter pylori chronically infect the human stomach and causes malabsorption of vitamin B(12) and folate in food, leading ultimately to an increase in circulating Hcy levels.. Forty-three patients with angiographically proven SCF (group I) were enrolled in this study; 43 cases with normal coronary flow pattern (group II) served as controls. Fasting plasma levels of Hcy, vitamin B(12), and folate were measured in all subjects. Presence of H. pylori infection was defined as positive 14 C urea breath test. Coronary flow patterns for each major epicardial coronary artery were determined with the Thrombolysis in Myocardial Infarction (TIMI) frame count method.. Mean TIMI frame count was 46.3 +/- 8.7 in group I and 24.3 +/- 2.9 in Group II (p = .0001). Vitamin B(12) levels were similar, whereas folate levels were dramatically reduced in group I compared to group II (13.2 +/- 4.3 vs. 17.1 +/- 5.2, p = .0001). Plasma Hcy levels were significantly higher in group I compared to group II (13.4 +/- 5.6 vs. 7.9 +/- 2.5, p = .0001) as was the prevalence of H. pylori infection (90.7% in group I vs. 58.1% in group II, p = .001). Hcy levels were elevated (11.7 +/- 5.3 vs. 7.5 +/- 2.7, p = .0001) and folate levels were reduced (13.9 +/- 4.7 vs. 18.6 +/- 4.9, p = .0001) in patients with H. pylori infection, while vitamin B(12) levels were similar in patients with and without H. pylori infection. Correlation analysis revealed a significant negative correlation between plasma folate and Hcy levels and also between folate levels and mean TIMI frame counts (r = -.33, p = .002 vs. r = -.33, p = .003). Moreover, there was a significant positive correlation between plasma Hcy levels and mean TIMI frame counts (r = .66, p = .0001). In addition, the folate level was the only significant determinant of the variance of Hcy in multiple regression analysis (r = -.21, p = .03).. Our data showed that plasma folate levels were decreased and plasma Hcy levels were increased in patients with SCF compared to controls. Also, the prevalence of H. pylori infection was increased in patients with SCF. These findings suggest that elevated levels of plasma Hcy, possibly caused by H. pylori infection, and/or a possible disturbance in its metabolism may play a role in the pathogenesis of SCF.

Topics: Adult; Blood Flow Velocity; Cardiovascular Diseases; Coronary Circulation; Female; Folic Acid; Helicobacter Infections; Homocysteine; Humans; Male; Middle Aged; Risk Factors; Vitamin B 12

Topics: Aged; Aged, 80 and over; Aging; Cognition Disorders; Dementia; Folic Acid Deficiency; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Homocysteine; Humans; Risk Factors; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Helicobacter Infections; Helicobacter pylori; Humans; Malabsorption Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Helicobacter Infections; Humans; Malabsorption Syndromes; Vitamin B 12; Vitamin B 12 Deficiency

In this study, we have aimed to show the possible relation between atrophic gastritis and premature atherosclerosis via hyperhomocysteinemia.. Thirty-four patients with atrophic gastritis were enrolled to the study. The control group consisted of 35 patients with non-atrophic gastritis. Classical cardiovascular disease risk factors did not significantly differ between atrophic gastritis and control subjects. The presence and degree of atrophic gastritis were assessed histologically and Helicobacter pylori infection was determined by both histologic and serologic methods. Body mass index was measured by standard technique blood fasting glucose, serum creatinine, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, vitamin B12, folic acid, and homocysteine levels were measured by biochemical methods. Carotid intima-media thickness was measured by B-mode ultrasonography to examine the premature atherosclerosis.. Plasma vitamin B12 levels were significantly lower (p = .00) and homocysteine levels were significantly higher (p = .01) in the atrophic gastritis group. There was no statistically significant difference in plasma folic acid levels between the two groups (p = .728). Carotid intima-media thickness was higher in the atrophic gastritis group than in the control group (0.516 mm versus 0.465 mm), but this difference did not show any statistical significance (p = .062).. Our results showed that atrophic gastritis may cause hyperhomocysteinemia, which is an independent risk factor for atherosclerosis and cardiovascular diseases. However, when compared with controls, carotid intima-media thickness of the atrophic gastritis patients was found to be higher but did not reach statistically significant levels.

Topics: Atherosclerosis; Carotid Arteries; Female; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Humans; Hyperhomocysteinemia; Male; Middle Aged; Prevalence; Ultrasonography; Vitamin B 12

Helicobacter pylori has been identified as a possible cause of vitamin B12 deficiency in the general population. We assessed any potential relationship between low cyanocobalamin serum levels and Helicobacter pylori status in hemodialysis patients and subsequently correlated these results with the existence of anemia (a common complication in hemodialysis patients), and macrocytosis.. In 29 chronic hemodialysis patients, active H. pylori infection was diagnosed using two different methods regardless of digestive symptoms: by searching for bacterial antigens in stools and by the detection of urea breakdown through breath testing. If these results were non-coincident, gastroscopy was performed and antral biopsies obtained. Patients were subsequently divided into group A (H. pylori-positive, n = 8, 28%) and group B (H. pylori-negative, n = 21, 72%). The corresponding initial values of erythrocytic folic acid, vitamin B12 and homocysteine prior to the first hemodialysis session of each patient were retrospectively collected.. Vitamin B12 levels (normal 200- 900 pg/ml) were significantly lower in group A compared to group B (225.4 +/- 111.9 vs. 707.9 +/- 258.3 pg/ml, p < 0.011). In group A, 5 patients (63%) had vitamin B12 deficiency (154 +/- 24.6 pg/ml). Baseline hematocrits, erythrocyte folic acid and serum homocysteine levels were not different between the groups, but mean corpuscular volumes were significantly higher in group A compared to group B (109.7 +/-14.1 vs. 91.8 +/- 8.8 fl, p = 0.002).. H. pylori-positive chronic hemodialysis patients may present with lower vitamin B12 blood levels and macrocytosis. H. pylori infection should be suspected in this population when low or low-normal vitamin B12 levels or macrocytosis exist.

Topics: Anemia, Macrocytic; Female; Folic Acid; Helicobacter Infections; Helicobacter pylori; Homocysteine; Humans; Kidney Failure, Chronic; Male; Middle Aged; Prevalence; Renal Dialysis; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

We examined the prevalence of vitamin B(12) deficiency and its association with medication use and characteristics, including infection with Helicobacter pylori (H. pylori), in 255 patients hospitalized for cardiovascular disease. In almost half of the study population, vitamin B(12) deficiency was found; patients using acetylsalicylic acid were more frequently vitamin B(12) deficient in comparison to nonusers (p = 0.02). Fifty-one percent of the patients were infected with H. pylori, and fewer infected patients were vitamin B(12) deficient.

Topics: Age Factors; Aged; Anti-Inflammatory Agents, Non-Steroidal; Antibodies, Viral; Aspirin; Biomarkers; Cardiovascular Diseases; Female; Helicobacter Infections; Humans; Male; Middle Aged; Netherlands; Platelet Aggregation Inhibitors; Prevalence; Statistics as Topic; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency

We present 62 yrs old patient in whom megaloblastic anaemia due to vitamin B12 depletion was caused by Helicobacter pylori infection. An eradication treatment with the vitamin B12 supplementation within 7 days resulted in withdrawal of the abnormalities in the blood smear. The inflammation of gastric mucosa with intestine metaplasia is still observed. According to the letters these changes may persist up to 2-3 years after treatment ending.

Topics: Anemia, Megaloblastic; Gastric Mucosa; Helicobacter Infections; Humans; Male; Middle Aged; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency

Both infection with Helicobacter pylori and alcohol abuse have been associated with low vitamin B12 serum levels. The interaction between both risk factors is unknown. The aim of this study was to determine whether Helicobacter pylori infection is associated with low vitamin B12 levels in alcohol dependent patients. Blood samples were obtained from adult alcohol dependent patients undergoing detoxification and analyzed for serum vitamin B12 levels. Helicobacter pylori infection was serologically measured. Patient characteristics, medication use and alcohol consumption at admission were assessed by interview. A total of 6 out of 89 patients included presented low vitamin B12 levels, all were sub clinical deficient (<250 pmol/L) and none were clinical deficient (<150 pmol/L). Infection with Helicobacter pylori was present in 29% of the patients. The average vitamin B12 levels in Helicobacter pylori seropositive and seronegative patients were 1,033 pmol/L (SD 741) and 971 pmol/L (SD 717), respectively. The relation between Helicobacter pylori infection and vitamin B12 deficiency was not of significance (OR=0.48; 95% CI [0.05-4.32]). In conclusion, Helicobacter pylori infection is not a risk factor for low vitamin B12 levels in alcohol dependent patients.

Topics: Adult; Alcoholism; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Risk Factors; Vitamin B 12; Vitamin B 12 Deficiency

The authors investigated whether low vitamin B12 intake, impaired gastric function, infection, and bacterial overgrowth were risk factors for the high prevalence of cobalamin deficiency observed in Guatemalan children.. The plasma cobalamin concentration of 556 school children was measured and classified as low, marginal, or adequate. In 60 children from each of these three groups, concentrations of serum methylmalonic acid (MMA), plasma homocysteine, and plasma holotranscobalamin II were measured, and usual dietary B12 intake was estimated. Serum gastrin and pepsinogen I concentrations were measured, and and bacterial overgrowth were diagnosed using C-urea and C-xylose breath tests, respectively.. infection was present in 83% (144 of 174) of children, and bacterial overgrowth was found in 25% (28 of 113). Children with infection had higher serum gastrin and pepsinogen I. There were no significant differences among the plasma cobalamin groups in the prevalence of infection, bacterial overgrowth, serum gastrin, or pepsinogen I concentrations. However, there was a significant positive correlation between serum MMA and gastrin concentrations. The average daily consumption of dietary B12 was 5.5 +/- 5.2 microg/day, but intakes for 23% of children were <1.8 micro g/day. B12 intake from fortified snacks added an additional 0.3 +/- 0.2 microg/day. B12 intake was not significantly different among the plasma cobalamin groups, but it was significantly correlated with plasma cobalamin.. The specific cause of cobalamin deficiency in this population remains unclear, but these results suggest that low dietary B12 intake is a risk factor and alterations in gastric secretions may also play a role.

Topics: Analysis of Variance; Breath Tests; Child; Diet; Female; Gastrins; Guatemala; Helicobacter Infections; Helicobacter pylori; Homocysteine; Humans; Male; Methylmalonic Acid; Pepsinogen A; Risk Factors; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

To determine whether serum vitamin B12 levels in non-vitamin B12 deficient healthy adults correlate with serological evidence of H. pylori infection.. An association between H. pylori infection and vitamin B12 deficiency has been recently reported.. 133 adults, presenting to a community based primary care clinic who met the following exclusion criteria; history of H. pylori eradication or antacid use, liver disease, inflammatory bowel disease, previous gastrointestinal surgery, a vegetarian diet or multivitamin supplementation were studied. Blood was drawn for a complete blood count, serum vitamin B12, gastrin, folic acid and H. pylori IgG antibodies. Subjects with vitamin B12 < or = 145 ng/mL (deficient range) were excluded.. Of 133 subjects 96 (72.2%) were seropositive for H. pylori IgG antibodies (HP+). Age of HP(+) subjects did not differ from that of seronegative subjects (HP-); 52.8 +/- 1.6 mean +/- SE versus 49.2 +/- 2.9 ( = NS). Prevalence of HP seropositivity was significantly higher among subjects with borderline (>145-180 pg/mL) or low normal (>180-250 pg/mL) vitamin B12 levels than among those with vitamin B12 > 250 pg/mL; among 25 subjects with vitamin B12 > 145-180 pg/mL 92% were seropositive and among 47 subjects with vitamin B12 > 180-250 pg/mL 89% were seropositive as compared with 31/61 (51%) of subjects with B12 > 250 pg/mL, Fisher exact test < 0.0001. Vitamin B12 levels did not correlate with age (r = -0.07). Gastrin levels (pg/mL) did not differ significantly between groups; 70.2 +/- 5.8 in HP(+) versus 56.0 +/- 12.4 in HP(-).. The higher prevalence of H. pylori infection among subjects with serum vitamin B12 levels that are within the lower end of the normal range suggests a causal relationship between H pylori infection and vitamin B12 levels in healthy adults.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers; Erythrocyte Indices; Female; Folic Acid; Gastrins; Helicobacter Infections; Helicobacter pylori; Hematocrit; Hemoglobins; Humans; Immunoglobulin G; Intrinsic Factor; Male; Middle Aged; Parietal Cells, Gastric; Prevalence; Reference Values; Seroepidemiologic Studies; Statistics as Topic; Vitamin B 12

Hyperhomocysteinemia, a risk factor for vascular disease, may be a particular problem in Asian Indians, but information is limited, especially in the U.S., despite its growing Asian population. Moreover, suggestions have been made that folate deficiency is responsible for the hyperhomocysteinemia in Indians. Therefore, we studied homocysteine status in healthy Asian Indians in the U.S. prospectively, determined the frequency of cobalamin and folate deficiency as contributors to it, and examined whether food-cobalamin absorption contributed to cobalamin deficiency. Homocysteine levels were higher in Asian Indian men than in 4 other ethnic groups (P < 0.0001); 10/39 Indian men (25.6%) were hyperhomocysteinemic. Cobalamin levels were lower in Indian men (P = 0.000005) and women (P = 0.03) than in non-Indians; low levels were found more frequently in both Indian men (23/39; 59.0%) and women (5/21; 23.8%) than in others. Measuring methylmalonic acid in 10 selected subjects showed that the low cobalamin levels reflected cobalamin deficiency, and high methylmalonic acid levels were found in some subjects without hyperhomocysteinemia. Evidence of folate deficiency was not found in any subjects. Food-cobalamin absorption was normal in all 13 Indian subjects tested, including those with Helicobacter pylori infection. The results show that hyperhomocysteinemia is strikingly common in apparently healthy, young Asian Indian men. The cause appears to be cobalamin deficiency, which affected more than half of the Indian men, may be largely subclinical, is underestimated by homocysteine levels alone which were not always abnormal, and is probably largely dietary in origin. Folate deficiency is rare. This public health problem is amenable to prevention and treatment in this growing segment of the U.S. population. It was, parenthetically, noteworthy that many of the affected subjects were young physician trainees.

Topics: Adult; Diet, Vegetarian; Female; Folic Acid; Helicobacter Infections; Helicobacter pylori; Homocysteine; Humans; Hyperhomocysteinemia; India; Malabsorption Syndromes; Male; Sex Factors; United States; Vitamin B 12; Vitamin B 12 Deficiency

Cobalamin (vitamin B12) deficiency is associated with Helicobacter pylori infection. This study examined how serum vitamin B12 levels relate to gastric mucosa H. pylori density and histology, and to hematological findings in patients with minimal or no gastric atrophy. A second aim was to confirm that H. pylori eradication therapy increases serum B12.. Biopsies of the gastric mucosa from a population of dyspeptic patients were graded for level of chronic inflammation, neutrophil activity, atrophy, and H. pylori density. A total of 145 H. pylori-infected patients with minimal or no atrophy were included in the study. Serum cobalamin level, hemoglobin level, and mean corpuscular volume were measured in the 145 patients before eradication therapy, and in 65 of the subjects after treatment. The hematologic findings before and after eradication therapy and correlations between serum vitamin B12 level and histologic parameters, hematologic findings, and patient age were statistically analyzed.. There was no significant correlation between serum cobalamin level and patient age. Before treatment all the histopathological scores were inversely correlated with serum vitamin B12 level (p <.01) on univariate analysis. Only H. pylori density was significantly associated with B12 level on multivariate analysis. Serum hemoglobin and cobalamin levels were significantly increased after treatment, regardless of H. pylori eradication status (p <.001).. The findings provide strong evidence that H. pylori infection is associated with cobalamin deficiency, and show that this is true even in patients with non-ulcer dyspepsia and minimal or no gastric atrophy.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Dyspepsia; Erythrocyte Indices; Female; Gastric Mucosa; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Hemoglobins; Humans; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

The aim of this study was to test the hypothesis that chronic atrophic gastritis induced by Helicobacter pylori (H. pylori) causes malabsorption of vitamin B12 and folate in food, leading ultimately to an increase in circulating homocysteine levels.. We performed endoscopy with stomach biopsy and measured fasting plasma homocysteine, vitamin B12, and folate levels in 93 patients who underwent diagnostic coronary arteriography. The patients were divided into two groups according to the presence (n = 57) or absence (n = 36) of H. pylori infection. Positive H. pylori infection was defined as positive H. pylori histology of biopsy specimens from the stomach. The extent of atrophic gastritis was endoscopically graded from 0 to 6.. There were no differences in age, sex, or traditional coronary risk factors between the two groups. Atrophy scores of the stomach were greater in patients with H. pylori infection than in patients without (3.9 +/- 1.4 vs 2.2 +/- 1.8, p < 0.0001). Patients with H. pylori infection had lower levels of vitamin B12 (630 +/- 222 vs 747 +/- 259 pg/ml, p = 0.02) and folate (6.2 +/- 2.1 vs 7.4 +/- 2.8, p = 0.046), as well as higher levels of homocysteine (11 +/- 4.9 vs 8.3 +/- 2.1 nmol/ml, p = 0.01), than did patients without H. pylori infection. Plasma homocysteine levels correlated inversely with plasma vitamin B12 and folate levels and positively with atrophic scores.. This study suggests that H. pylori-induced chronic atrophic gastritis decreases plasma vitamin B12 and folic acid levels, thereby increasing homocysteine levels. However, this effect does not seem to be strong.

Topics: Aged; Coronary Angiography; Coronary Artery Disease; Female; Folic Acid; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Homocysteine; Humans; Malabsorption Syndromes; Male; Middle Aged; Risk Factors; Vitamin B 12

Food-cobalamin malabsorption is common in patients with low cobalamin levels. However, characterization of affected subjects has been limited. The aim of this study was to analyze demographic and gastric data in a large study population.. Data were collected prospectively in 202 subjects (43 volunteers and 159 patients) who underwent the egg yolk-cobalamin absorption test (EYCAT). H. pylori status was determined in 167 of the subjects, serum gastrin and antiparietal cell antibody in 158 and pepsinogen (PG) I and PG II levels in 133.. Latin American and black patients had lower EYCAT results than did white or Asian-American ones (p = 0.0001) and had severe food-cobalamin malabsorption (EYCAT < 1%) more often (p = 0.0001). Age correlated inversely with EYCAT results (p = 0.02). H. pylori infection was associated with food-cobalamin malabsorption (p = 0.0001), especially with severe malabsorption where 29/37 subjects (78.4%) were infected. Malabsorption was also associated with higher gastrin levels (p = 0.0001) and lower PG I levels (p = 0.01) and PG I:PG II ratios (p = 0.0001). Multivariate analysis showed that ethnic origin, gastrin levels, H. pylori infection and, to a lesser extent, age were independently associated with the EYCAT results.. Latin American and black patients have food-cobalamin malabsorption more often than do white and Asian-American patients. This association is independent of the malabsorption's association with H. pylori infection, markers of gastritis, such as gastrin, and older age. The patterns of gastric tests suggest that malabsorption may be due to diverse mechanisms, not just atrophic gastritis. The possible role of H. pylori infection in many cases of severe food-cobalamin malabsorption also suggests avenues of treatment and prevention.

Topics: Adult; Age Distribution; Aged; Aged, 80 and over; Asian People; Biomarkers; Black People; Cohort Studies; Comorbidity; Female; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Linear Models; Logistic Models; Malabsorption Syndromes; Male; Middle Aged; Prospective Studies; Sensitivity and Specificity; Severity of Illness Index; Vitamin B 12; White People

The aim of this study was to determine whether a relationship exists between gastric and oral Helicobacter pylori and oral hygiene in patients with vitamin B12 deficiency.. One hundred eight patients with vitamin B12 deficiency who were H pylori -positive in their gastric mucosa were enrolled in the study. These patients were divided into 3 groups determined by Oral Hygiene Index (OHI) scores of good, fair, or poor. H pylori was detected in the dental plaque with camphylobacter-like organism test gels. All patients were treated with a combination regimen to eradicate H pylori.. H pylori positivity in dental plaque was correlated with OHI scores; the positivity was 28.5%, 90.2%, or 100% in patients with good, fair, or poor OHI scores, respectively. The eradication of H pylori was associated with recovery from anemia and increased serum vitamin B12 level (P <.0001 and P <.0001). The patients with poor OHI scores had the most frequent gastric recurrence of H pylori (58.3%) compared with those with fair OHI scores (41.2%) and good OHI scores (4.8%).. H pylori seems to be an etiologic factor in vitamin B12 deficiency, since anemia was cured and the level of vitamin B12 in the serum increased as a result of its eradication. However, eradication of H pylori from gastric mucosa alone is not enough to prevent gastric recurrence of the bacteria. Proper oral hygiene must be established to eliminate H pylori in dental plaque. Therefore, we suggest that control of H pylori in dental plaque is necessary to control recurrence of H pylori.

Topics: Adult; Aged; Aged, 80 and over; Amoxicillin; Anemia, Pernicious; Anti-Bacterial Agents; Anti-Ulcer Agents; Campylobacter; Chi-Square Distribution; Clarithromycin; Dental Calculus; Dental Plaque; Female; Gastric Mucosa; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Omeprazole; Oral Hygiene; Oral Hygiene Index; Penicillins; Recurrence; Statistics as Topic; Stomach Diseases; Vitamin B 12; Vitamin B 12 Deficiency

The reason for the high prevalence of mild cobalamin (vitamin B-12) deficiency in the elderly is poorly understood.. We aimed to determine the reason for this high prevalence.. We examined cobalamin intake, the presence and severity of atrophic gastritis, the presence of Helicobacter pylori infection, and plasma cobalamin and methylmalonic acid (MMA) concentrations in 105 healthy, free-living, older subjects aged 74-80 y.. Mild cobalamin deficiency, ie, low to low-normal plasma cobalamin concentrations (< 260 pmol/L) and elevated plasma MMA concentrations (> 0.32 micromol/L), were found in 23.8% of subjects; 25.7% of subjects were not cobalamin deficient (plasma cobalamin > or = 260 pmol/L and plasma MMA < or = 0.32 micromol/L). Six subjects (5.8%), including 1 with mild cobalamin deficiency, had dietary cobalamin intakes below the Dutch recommended dietary intake of 2.5 microg/d. Mildly cobalamin-deficient subjects had lower total (diet plus supplements) cobalamin intakes (median: 4.9 microg/d; 25th and 75th percentiles: 3.9, 6.4) than did non-cobalamin-deficient subjects (median: 6.3 microg/d; 25th and 75th percentiles: 5.4, 7.9) (P = 0.0336), mainly because of less frequent use of cobalamin supplements (8% compared with 29.6%; chi2 = 3.9, P = 0.048). Atrophic gastritis was found in 32.4% of the total study group: mild to moderate in 19.6% and severe in 12.7%. The prevalence of severe atrophic gastritis, but not mild-to-moderate atrophic gastritis, was higher in mildly cobalamin-deficient subjects (25%) than in non-cobalamin-deficient subjects (3.7%) (chi2 = 4.6, P = 0.032). The prevalence of immunoglobulin G antibodies to H. pylori was similar in mildly cobalamin-deficient subjects (54.2%) and in non-cobalamin-deficient subjects (44.4%) (chi2 = 0.5, P = 0.5).. The high prevalence of mild cobalamin deficiency in healthy, free-living, older Dutch subjects could be explained by inadequate cobalamin intake or severe atrophic gastritis in only 28% of the study population. Other mechanisms explaining mild cobalamin deficiency in older people must be sought.

Topics: Aged; Aged, 80 and over; Female; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Humans; Male; Methylmalonic Acid; Prevalence; Vitamin B 12; Vitamin B 12 Deficiency